Menstrual Hygiene 101: Dignity, Access, and Education for All

Prepared by Claudia Ng and Vyshnavi Charrlotte

28 May 2025

Every month, 28-year-old Mira from a coastal village in Sabah tears strips from her old T-shirts to use as makeshift sanitary pads when she runs out of supplies. With only 20 pads to share between herself, her mother, and her sister, Mira turns to cloth as a last resort. Once soiled, she rinses it in seawater, dries it, and reuses it for the rest of her period. It’s a routine born not out of choice, but necessity—one that highlights the stark reality of period poverty in Malaysia. On average, women use about 15 to 20 pads per menstrual cycle, although this can vary depending on flow intensity, cycle length, and personal habits. Those with lighter periods use closer to 10–15 pads, while those with heavier flow might need 20–30 or more. Mira is merely one story among thousands of women who must choose between their menstrual hygiene and basic survival. Many girls and women in Malaysia, like Mira, experience “period poverty” in Malaysia, which is the lack of access to menstrual products, knowledge on menstruation, or hygiene facilities.

This May 28th, we celebrate World Menstrual Hygiene Day—a global movement to break the silence, raise awareness, and push for action around menstrual health and hygiene. Mira’s experience, and that of countless others like her, is exactly why this day matters. It's not just about celebrating progress—it's about confronting the realities faced by millions of women and girls who still lack access to basic menstrual care.

According to the World Bank, an estimated 500 million lack access to menstrual products and adequate facilities for menstrual hygiene management (MHM). As of now, there is no current data that shows exactly what percentage of the population of girls and women in Malaysia is affected by period poverty. However, the National Population and Family Development Board’s (LPPKN) head of reproductive health unit, Dr Hamizah Mohd Hassan, has said on a panel that period poverty certainly affects women from the B40 group.

What Period Poverty Looks Like in Malaysia

Period poverty in Malaysia often goes unseen, but it’s very real. It looks like schoolgirls skipping class because they can't afford pads. It looks like women using coconut husks, banana leaves, or even newspapers to manage their periods. It looks like Mira, from Sabah, rationing 20 pads between three women.

This isn’t an isolated problem. It disproportionately affects women and girls in low-income groups, particularly those in the B40 category, as well as Orang Asli/Asal communities and refugees, who often live in remote areas with limited access to basic healthcare and menstrual products. For many of them, even RM5 for a pack of pads is a stretch, especially when food, electricity, and rent take priority.

Period poverty in Malaysia exists because of a mix of economic hardship, lack of awareness, cultural stigma, and gaps in public policy. Menstrual products are not classified as essential items, so there’s no government subsidy or price control. In rural or underserved communities, even where products are available, there’s often limited education around menstrual hygiene, leaving many girls unprepared and ashamed when they get their first period. Add to that the cultural taboos that surround menstruation in many communities, and you get a silence that keeps the problem hidden and untreated.

When Necessity Breeds Danger: Health Consequences of Period Poverty

When access to menstrual products becomes a luxury, the consequences ripple profoundly through the physical and psychological well-being of those affected, making period poverty not just a personal issue, but a public health one. Moreover, stigma and shame surrounding menstruation compound the problem, creating a barrier to open discussions and perpetuating neglect. When it comes to women’s rights, menstrual health and hygiene (MHH) becomes a proponent of women’s dignity, privacy, bodily integrity, and their self-efficacy. 

As a physiological necessity, menstruating individuals need to have adequate MMH practices. However, women who lack access to safe hygiene products are often compelled to ration; using available items for longer durations than recommended. Although it might help economically, studies have shown that using pads, tampons, or menstrual cups for extended periods may increase the risk of infections such as urinary tract infections (UTIs), reproductive tract infections (RTIs) and bacterial vaginosis. For instance, a study in Lebanon examined the rise of clinic visits for advanced-stage vulvar dermatitis and other diseases linked to poor MMH practice. 

Furthermore, Toxic Shock Syndrome (TSS), although rare, is a potentially life-threatening condition commonly associated with extended use of tampons or menstrual cups. Due to its fatal nature, TSS may lead to organ failure, amputation of limbs, and even death. When unable to access any period products, women resort to using improvised materials such as dirty clothes, rags, tissues, toilet paper, paper towels, and even children’s diapers as alternatives unfit for sustaining hygiene, thus increasing the risk of infections. 

Period poverty subjects individuals to immense psychological difficulties as well, highlighting the state of being stripped away from dignity and self-efficacy. For instance, Indonesian women during the COVID-19 pandemic who experienced period poverty reported heightened levels of psychological distress. The psychological burden of not having those needs met results in anxiety and depression, breeding a climate of psychological distress. Furthermore, the inadequate access to period products and facilities made young girls vulnerable to education disruptions, particularly in rural areas with unclean private sanitation facilities, hindering their mobility. These effects compound, resulting in the diminishing of self-esteem for many girls and women, perpetuating the vicious cycle of shame and scarcity.

Dignifying Period: The Need for Comprehensive Strategies to Combat Period Poverty

As a multifaceted issue that requires nuanced perspectives to address, solutions that encompass the provision of adequate sanitation facilities, increased affordability of products, education, and broader societal engagement are paramount. 

1) Introduce rights-based legislation and inclusive implementation

While reducing the economic burden of menstruation is a fundamental solution to end period poverty, the scope of the initiatives and how they are implemented determine the success of the initiative. Scotland, for instance, is the first country to establish The Period Products 2021, a legislative instrument that guarantees free period products within the premises of public spaces such as libraries, community centres, schools, and public toilets. This act ensures that hygiene products exist in various places, removing obstacles to access, especially for individuals in remote areas, victims of domestic abuse, and those without housing. Furthermore, this act allows flexibility in distribution methods that cater to different needs and abilities, allowing in-person collection and third-party collection. Scotland’s success is an example of how comprehensive, rights-based legislation, coupled with inclusive implementation and community engagement, is necessary to end period poverty. As of now, although a nationwide legislative framework akin to Scotland’s is yet to be established, the Malaysian government has taken steps such as providing free sanitary pads for teenagers from the B40 group under Budget 2022, reflecting its growing concern over period poverty in this country.

2) Establish comprehensive menstrual education

Education is a key factor in demystifying menstruation among girls and women. When young girls and women understand the biological processes that occur in their bodies, they feel more empowered to handle their periods, seeking medical assistance when necessary. Comprehensive menstrual education counters prevalent myths and misconceptions that deem the otherwise natural biological process as “dirty” or “unnatural”. Furthermore, prioritising awareness of MHH and reproductive health is essential for dismantling entrenched taboos and fostering informed, confident individuals who experience menstruation with dignity and respect. In Malaysia’s context, campaigns like “Haid, Jangan Hide” by the All Women’s Action Society (AWAM) serve as a milestone in normalising conversations around menstruation, stressing the importance of empowering girls and women through knowledge and a supportive environment.

3) Build private facilities in rural schools for better menstrual hygiene management 

The absence of private, gender segrated toilets in school often leads to absenteeism among menstruating girls. For instance, over 46% of schools in Timor-Leste lack gender separated toilets, leaving girls with no choice but to share facilities with boys, undermining safety and comfort. In Malaysia, over half of female students consider skipping school between one and three days each month during menstruation due to the inadequate access to sanitary products and facilities. The high incidence of absenteeism underscores the need for proper facilities that uphold MHH, necessitating appropriate access to water, soap, disposal mechanisms, and privacy. In Malaysia, this means building more private spaces in schools located in rural areas for better menstrual management, promoting lower rates of absenteeism and hygiene.

No More Shame

Mira’s story from Sabah exemplifies the pervasive issue of period poverty in Malaysia, where economic hardship, cultural stigma, and inadequate infrastructure converge to deny many women and girls their rights to MHH and dignity. The physical and mental toll associated with inadequate MHH management highlights the urgency of comprehensive solutions. Only by combining economic support, improved sanitation facilities, and comprehensive education can Malaysia fully capitalise on the benefits of a multifaceted approach. This year’s Menstrual Hygiene Day serves as a poignant reminder of the work that remains and the collective action required to ensure that individuals can safely menstruate without compromising their health and dignity.

References :

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